微量元素锌、血清胱抑素 C在糖尿病肾病早期诊断的意义

目的：探讨早期糖尿病肾病患者（ DN）的微量元素锌、血清胱抑素C（ CysC）、血清肌酐（ SCr）和血清尿素（ BUN）水平的变化程度及意义。方法将糖尿病肾病患者分为3组：正常蛋白尿组,微量蛋白尿组,临床蛋白尿组。所有患者和对照组均空腹抽取静脉血检测微量元素锌、血清胱抑素C、血清尿素、血清肌酐。结果正常蛋白尿组、微量蛋白尿组、临床蛋白尿组微量元素锌均明显低于正常对照组,差异有统计学意义（ P＜0.05）。正常蛋白尿组、微量蛋白尿组、临床蛋白尿组血清胱抑素C水平均明显高于正常对照组,差异有统计学意义（ P＜0.05）。微量蛋白尿组、临床蛋白尿组血清肌酐检测值和正常对照组有明显差异,差异有统计学意义（ P＜0.05）。结论检测微量元素锌、血清胱抑素C对糖尿病肾病的早期肾损害有较高的临床价值,可作为早期糖尿病肾病诊断的参考指标。     

2型糖尿病患者血清钙镁与甲状腺激素含量变化及临床意义

为了监测 2型糖尿病人血清钙、镁和甲状腺激素含量 ,分析其临床意义及相关性 ,应用放射免疫分析法测定了 1 1 5例 2型糖尿病及 1 5 0例健康人血清甲状腺激素含量。同时用美国杜邦RXL自动生化仪测定了其血清钙、镁含量。结果表明 ,在 2型糖尿病伴有明显并发症者血镁、FT3水平明显降低 (P <0 0 5 ) ,钙镁两种元素与甲状腺激素水平无明显相关性。 2型糖尿病患者适当补镁对预防其并发症是有益的 ,测定FT3 等可作为判断 2型糖尿病严重程度和估计预后的参考指标。     

多层螺旋CT用于诊断2型糖尿病足严重程度的价值分析

本研究的目的是探讨2型糖尿病(T2DM)患者糖尿病足中,应用多层螺旋CT(MSCT)的诊断价值。选取T2DM患者130例,其中合并糖尿病足患者35例(Wagner分级0～2级22例,3～4级为13例,无5级),单纯T2DM患者95例,给予MSCT检查。结果发现伴糖尿病足患者胫后动脉、腘动脉和股动脉截面积明显小于单纯T2DM患者(P0.05);Wagner级3～4级糖尿病足患者胫后动脉、腘动脉和股动脉截面积明显小于Wagner级0～2级糖尿病足患者(P0.05);胫后动脉、腘动脉和股动脉截面积诊断Wagner级3～4级糖尿病足的ROC曲线下面积分别为0.685、0.927和0.822(P0.05)。研究结果证实在诊断T2DM患者糖尿病足严重程度中,MSCT有一定应用价值,值得临床使用。     

血镁、血脂与脑血管病的关系

为探讨血清镁、血脂与脑血管疾病的关系 ,测定和比较了脑梗死 83例、脑出血 79例患者的血清镁 (Mg)、总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL -C)和低密度脂蛋白胆固醇 (LDL -C)水平 ,并与 3 2例非脑血管病患者进行了比较。结果表明 ,脑梗死组血清Mg、HDL -C水平降低均与对照组差异有显著性 (P <0 0 5或P <0 0 1 ) ,其中脑梗死组血清Mg明显低于脑出血组 (P <0 0 5 ) ;脑出血组血清Mg水平降低、TG水平升高均与对照组差异有显著性 (P <0 0 5或P <0 0 1 ) ;三组患者间的血清TC、LDL -C水平无明显差别。提示血清Mg和HDL-C水平降低以及血清TG水平升高可能是增加脑梗死和脑出血发生的危险因素。     

探讨尿蛋白和尿微量白蛋白在糖尿病肾病检验中的应用价值

目的对尿蛋白和尿微量白蛋白在糖尿病肾病检验中的应用价值进行评价分析,为今后的临床诊断工作提供有价值的参考信息。方法选择2013年5月—2015年5月间江西省上饶市广丰县中医院收治的符合临床诊断标准的糖尿病肾病患者56例以及同期健康体检者60例作为研究对象,对这两组受试者展开尿蛋白和尿微量白蛋白水平检测,并对检测结果进行对比分析。结果糖尿病肾病组患者尿蛋白、尿微量白蛋白阳性率较健康对照组发生显著升高(P0.05)。结论对患者展开尿蛋白和尿微量白蛋白水平检测,为临床糖尿病肾病的早期诊断提供可靠的参考依据,临床价值显著,值得关注并推广。     

重金属暴露与肾功能的关联性研究：基于代谢综合征人群的横断面研究证据

探索代谢综合征人群中重金属暴露与肾功能的相关性,为特定人群中慢性肾脏病的诊治提供新思路。基于2011—2018年美国健康与营养调查数据,纳入2 474名代谢综合征患者作为研究对象;探讨四种血液金属元素(包括镉、铅、硒、锰)对肾功能的影响。肾功能主要通过慢性肾病(CKD)、估计的肾小球滤过率(eGFR),尿微量白蛋白肌酐比(UACR)和尿酸(UA)评估。通过加权多因素Logistic回归模型及线性回归模型分析血液中金属元素水平与肾功能的关系。进一步按照年龄、性别、体质量指数(BMI)、是否患高血压、糖尿病及血脂异常进行亚组分析。研究发现血液中镉、铅水平与CKD的发生呈正相关,与eGFR呈现负相关。血硒与CKD的发生存在负向关联,而血锰与eGFR水平存在正相关(P<0.05)。而亚组分析结果显示,女性及老年代谢综合征患者对于金属暴露的效应更为敏感。代谢综合征人群中重金属暴露与肾功能存在关联,铅、镉暴露可能会导致肾功能受损,而硒、锰暴露则可能会起到一定的保护作用。     

富含微量元素中药煎剂对2型糖尿病疗效观察

为了观察富含微量元素中药煎剂对2型糖尿病（T2DM）的疗效,将门诊64名血糖控制不满意的T2DM患者分为增加富含微量元素中药煎剂组（观察组）和不增加组（对照组）,服药3个月后比较。结果表明,观察组的空腹血糖（FPG）、空腹血清胰岛素（Fins）和糖化血红蛋白（HbA1c）3月后明显下降（P〈0．01）;3月后观察组的FPG、Fins和HbA1c较对照组明显下降（P〈0．01）。可见增加富含微量元素中药煎剂对血糖难以控制的T2DM的FPG、Fins和HbA1c能够起到有效控制作用。     

糖尿病大鼠微量元素与动脉血栓形成的关系

为研究糖尿病大鼠微量元素的含量变化及其与动脉血栓形成的关系,用链脲佐菌素（STZ）诱导出糖尿病大鼠模型,三氯化铁（FeCl3）造颈总动脉血栓后,测定血糖、胰岛素（INS）、6-酮-前列腺素F1α（6-K-PGF1α）、血栓素B2（TXB2）、内皮素（ET1）以及全血微量元素镁、锌含量。结果表明,①与正常对照组比,糖尿病大鼠的血糖、TXB2、ET1和锌的含量、ρ（TXB2）／ρ（6-K-PGF1α）、（T／P）比值及血栓质量增加（P〈0．05）,INS含量降低（P〈0．001）,镁和6-K-PGF1α含量无改变（P〉0．05）;②糖尿病组的TXB2与糖、锌（P=0．001）、胰岛素正相关（P=0．003）,ET1仅与锌正相关（P=0．096）,6-K-PGF1α与镁、锌无相关关系。提示：①糖尿病大鼠血管内皮功能受损,血液处于T／P失衡的高凝状态,更易形成动脉血栓;②糖和锌代谢紊乱在T／P失衡和内皮功能损伤中有重要作用。     

Related Analysis on Type 2 Diabetes and Trace Elements

2型糖尿病是一种常见的内分泌及代谢紊乱疾病,人体必需微量元素直接影响细胞代谢和胰岛素的水平.综述了微量元素铬、锌、镁、硒、铁、铜与2型糖尿病(T2DM)相关性研究的进展,为临床糖尿病的预防和治疗提出建议.     

白血病骨髓移植病人全血微量元素铜的变化及其意义

为了研究白血病骨髓移植病人全血微量元素铜的变化及其意义 ,用原子吸收光谱法检测了正常对照组与白血病骨髓移植患者预处理前及移植后骨髓空虚期全血微量元素铜的含量。结果表明 ,正常对照组全血铜浓度与白血病骨髓移植患者预处理前全血铜浓度差异无显著性 (P >0 0 5 ) ,而与骨髓空虚期全血铜浓度有显著性差异 (P <0 0 5 ) ,说明白血病缓解后血铜接近正常对照组水平 ,而白血病骨髓移植患者预处理后骨髓空虚期全血铜含量高于正常对照组 ,说明预处理影响微量元素铜的代谢 ,本文就其影响机理进行了研究     

HPLC同时检测血清和尿样中肌酐、假尿苷、尿酸

用反相高效液相色谱法同时测定了３９例糖尿病患者的血清和尿样中的假尿嘧啶核苷、肌酐和尿酸,并与２４ｈ尿白蛋白排泄量进行了比较分析。发现血清假尿嘧啶核苷是糖尿病肾病早期诊断的一种新颖而敏感的指标,有助于连续监测肾脏的功能状态以了解病程的转归。     

Phospholipidomic identification of potential plasma biomarkers associated with type 2 diabetes mellitus and diabetic nephropathy

Type 2 diabetes mellitus (T2DM) and its attendant complications, such as diabetic nephropathy (DN), impose a significant societal and economic burden. The investigation of discovering potential biomarkers for T2DM and DN will facilitate the prediction and prevention of diabetes. Phospholipids (PLs) and their metabolisms are closely allied to nosogenesis and aggravation of T2DM and DN. The aim of this study is to characterize the human plasma phospholipids in T2DM and DN to identify potential biomarkers of T2DM and DN. Normal phase liquid chromatography coupled with time of flight mass spectrometry (NPLC-TOF/MS) was applied to the plasma phospholipids metabolic profiling of T2DM and DN. The plasma samples from control (n = 30), T2DM subjects (n = 30), and DN subjects (n = 52) were collected and analyzed. The significant difference in metabolic profiling was observed between healthy control group and DM group as well as between control group and DN group by the help of partial least squares discriminant analysis (PLS-DA). PLS-DA and one-way analysis of variance (ANOVA) were successfully used to screen out potential biomarkers from complex mass spectrometry data. The identification of molecular components of potential biomarkers was performed on Ion trap-MS/MS. An external standard method was applied to quantitative analysis of potential biomarkers. As a result, 18 compounds in 7 PL classes with significant regulation in patients compared with healthy controls were regarded as potential biomarkers for T2DM or DN. Among them, 3 DM-specific biomarkers, 8 DN-specific biomarkers and 7 common biomarkers to DM and DN were identified. Ultimately, 2 novel biomarkers, i.e., PI C18:0/22:6 and SM dC18:0/20:2, can be used to discriminate healthy individuals, T2DM cases and DN cases from each other group.     

UHPLC-MS-Based Serum and Urine Metabolomics Reveals the Anti-Diabetic Mechanism of Ginsenoside Re in Type 2 Diabetic Rats

Panax ginseng was employed in the treatment of “Xiao-Ke” symptom, which nowadays known as diabetes mellitus, in traditional Chinese medicine for more than a thousand years. Ginsenoside Re was the major pharmacologic ingredient found abundantly in ginseng. However, the anti-diabetic of Ginsenoside Re and its underlying mechanism in metabolic level are still unclear. Serum and urine metabolomic method was carried out to investigate the anti-diabetic pharmacological effects and the potential mechanism of Ginsenoside Re on high-fat diet combined streptozotocin-induced type 2 diabetes mellitus (T2DM) rats based on ultra-high-performance liquid chromatography coupled with quadrupole exactive orbitrap mass spectrometry (UHPLC-Q-Exactive Orbitrap/MS). Serum and urine samples were collected from the control group (CON), T2DM group, metformin (MET) treatment group, and ginsenoside Re treatment group after intervention. The biochemical parameters of serum were firstly analyzed. The endogenous metabolites in serum and urine were detected by UHPLC-MS. The potential metabolites were screened by multivariate statistical analysis and identified by accurate mass measurement, MS/MS, and metabolite databases. The anti-diabetic-related metabolites were analyzed by KEGG metabolic pathway, and its potential mechanism was discussed. The treatment of ginsenoside Re significantly reduced the blood glucose and serum lipid level improved the oxidative stress caused by T2DM. Biochemical parameters (urea nitrogen, uric acid) showed that ginsenoside Re could improve renal function in T2DM rats. Respective 2 and 6 differential metabolites were found and identified in serum and urine of ginsenoside Re compared with T2DM group and enriched in KEGG pathway. Metabolic pathways analysis indicated that the differential metabolites related to T2DM were mainly involved in arachidonic acid metabolism, Vitamin B6, steroid hormone biosynthesis, and bile secretion metabolic pathways. This study verified the anti-diabetic and anti-oxidation effects of ginsenoside Re, elaborated that ginsenoside Re has a good regulation of the metabolic disorder in T2DM rats, which could promote insulin secretion, stimulated cannabinoid type 1 receptor (CB₁), and CaMKK β to activate AMPK signaling pathway, inhibited insulin resistance, and improved blood glucose uptake and diabetic nephropathy, so as to play the role of anti-diabetic.     

Metabonomics research of diabetic nephropathy and type 2 diabetes mellitus based on UPLC-oaTOF-MS system

Ultra performance liquid chromatography (UPLC) coupled with orthogonal acceleration time-of-flight (oaTOF) mass spectrometry has showed great potential in diabetes research. In this paper, a UPLC-oaTOF-MS system was employed to distinguish the global serum profiles of 8 diabetic nephropathy (DN) patients, 33 type 2 diabetes mellitus (T2DM) patients and 25 healthy volunteers, and tried to find potential biomarkers. The UPLC system produced information-rich chromatograms with typical measured peak widths of 4 s, generating peak capacities of 225 in 15 min. Furthermore, principal component analysis (PCA) was used for group differentiation and marker selection. As shown in the scores plot, the distinct clustering between the patients and controls was observed, and DN and T2DM patients were also separated into two individual groups. Several compounds were tentatively identified based on accurate mass, isotopic pattern and MS/MS information. In addition, significant changes in the serum level of leucine, dihydrosphingosine and phytoshpingosine were noted, indicating the perturbations of amino acid metabolism and phospholipid metabolism in diabetic diseases, which having implications in clinical diagnosis and treatment.     

85例脏器移植患者手术前后血清镁、锌含量的变化

对85例脏器移植患者（45例肝移植,40例肾移植）手术前、后进行了血清Mg、Zn含量的检测。结果表明：肝、肾移植患者术后血Mg水平较术前正常水平均明显降低（P＜0．01）。肝移植患者术后血Zn水平有一过性降低现象,肾移植患者术前、术后血Zn水平均明显低于正常对照组（P＜0．001）。研究结果提示,应重视肝、肾移植患者手术后出现的低镁血症和低锌血症,并做适当的补充。     

基于UPLC-oaTOF-MS的糖尿病及糖尿病肾病的代谢组学研究

以糖尿病患者、糖尿病肾病患者和正常人的血清为研究对象, 采用超高效液相色谱-飞行时间质谱建立其代谢指纹图谱, 并结合主成分分析进行模式识别, 实现患者和正常人的区分, 并试图发现潜在的标志物.     

肝硬化患者血清微量元素与免疫功能的相关性研究

为探讨肝硬化患者血清中微量元素含量与细胞免疫功能的相关性,将70例肝硬化患者根据代偿期及失代偿期分为两组,30例健康体检者为对照组,用日立7170A型全自动生化分析仪检测了血清中的镁、铁、铜、锌含量,流式细胞技术检查了外周血CD3+、CD4+、CD8+、NK细胞。结果表明,肝硬化患者血清镁、铁、锌水平显著低于对照组;血清铜水平显著高于对照组;CD3+、CD4+、NK细胞低于正常对照组,以失代偿期改变明显。肝硬化患者血清铜水平与CD3+、CD4+、NK细胞呈负相关,血清锌水平与CD3+、CD4+、NK细胞呈正相关。提示肝硬化患者微量元素代谢异常与细胞免疫功能下降有一定的联系。     

Diet control to achieve euglycemia induces significant loss of heart and liver weight via increased autophagy compared with ad libitum diet in diabetic rats

Intensive glucose control increases the all-cause mortality in type 2 diabetes mellitus (T2DM); however, the underlying mechanisms remain unclear. We hypothesized that strict diet control to achieve euglycemia in diabetes damages major organs, increasing the mortality risk. To evaluate effects on major organs when euglycemia is obtained by diet control, we generated a model of end-stage T2DM in 13-week-old Sprague-Dawley rats by subtotal pancreatectomy, followed by ad libitum feeding for 5 weeks. We divided these rats into two groups and for the subsequent 6 weeks provided ad libitum feeding to half (AL, n=12) and a calorie-controlled diet to the other half (R, n=12). To avoid hypoglycemia, the degree of calorie restriction in the R group was isocaloric (g per kg body weight per day) compared with a sham-operated control group (C, n=12). During the 6-week diet control period, AL rats ate three times more than rats in the C or R groups, developing hyperglycemia with renal hyperplasia. R group achieved euglycemia but lost overall body weight significantly compared with the C or AL group (49 or 22%, respectively), heart weight (39 or 23%, respectively) and liver weight (50 or 46%, respectively). Autophagy levels in the heart and liver were the highest in the R group (P<0.01), which also had the lowest pAkt/Akt levels among the groups (P<0.05 in the heart; P<0.01 in the liver). In conclusion, glycemic control achieved by diet control can prevent hyperglycemia-induced renal hyperplasia in diabetes but may be deleterious even at isocaloric rate when insulin is deficient because of significant loss of heart and liver mass via increased autophagy.